Active NPI
Timothy D Oliver, MD
- Family Medicine Physician
- Owosso, MI
National Provider Identifier
1861415705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301041058
- Practice address
- 818 W King St Ste 101
Owosso, MI 48867-2117 - Phone
- (989) 725-8171
- Fax
- (989) 723-1257
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301041058 | MI | Primary |
Addresses
Primary practice location
818 W King St Ste 101
Owosso, MI 48867-2117
Mailing address
818 W King St Ste 101
Owosso, MI 48867-2117
Phone (989) 725-8171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861415705 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301041058 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- timothyoliver@memh.allscriptsdirect.net
- t.oliver@memorialhealthcare.midirect.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655337600000",
"number": "1861415705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "818 W KING ST STE 101",
"city": "OWOSSO",
"state": "MI",
"postal_code": "488672117",
"telephone_number": "989-725-8171",
"fax_number": "989-723-1257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "818 W KING ST STE 101",
"city": "OWOSSO",
"state": "MI",
"postal_code": "488672117",
"telephone_number": "989-725-8171",
"fax_number": "989-723-1257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVER",
"first_name": "TIMOTHY",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2022-06-16",
"certification_date": "2022-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301041058",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1861415705",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Owosso, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.